At ONS congress 2006, an evidence-based standard of care for the prevention and treatment of oral mucositis was presented by this group of nurses. Approval for the new standard was obtained from this NCI designated Cancer Center's medical board, clinical council, and executive nursing committee. Variations in nursing practice triggered this project. This new standard of care has been fully implemented throughout all disease management teams of the ambulatory, inpatient, and chemotherapy areas. This presentation will describe challenges to achieving this evidence- based practice change and strategies used to overcome them. Changes to institutional supply of toothbrushes and rinse agents were requested based on the evidence, as part of a new oral care protocol. Cost analysis and potential benefit were presented to several committees, and finally approved. Nursing education presented the greatest challenge. A new assessment tool (CTCAE V.3) and oral care protocol were presented at a series of in-services. An animated PowerPoint presentation enabled nurses to grade varied photos of mucositis and compare their assessment with the actual toxicity grade for self-directed learning. Common terms were defined and clarified to increase nurses' fluency regarding mucositis. Videos were developed summarizing the evidence, new tool, and oral care protocol. These were used for unit based in-services and placed on the intra-net to target nurses at regional sites whose education presented a geographic challenge. These videos have been incorporated into annual competency review and orientation for all nurses. Advanced practice nurses were recruited as trainers and resources. A single patient education booklet reflective of the new oral protocol replaced three previous documents. Noted challenges included maintaining literacy parameters and utilizing feedback from expert review. Mucositis assessment and management are documented on multiple forms spanning this institution. Arduous revisions were necessary to reflect the new mucositis grading system. Documentation reviews and practice surveys will discern impact on nursing practice. Promoting development of evidence-based practices has become conventional at many institutions. However, implementing these changes proved more complex than initially anticipated. Each challenge was met with different strategies for accomplishing the goal. Communication, flexibility, and cooperation proved imperative to successful implementation of this practice change.

Repository Posting Date:

27-Oct-2011

Date of Publication:

27-Oct-2011

Conference Date:

2007

Conference Name:

32nd Annual Oncology Nursing Society Congress

Conference Host:

Oncology Nursing Society

Conference Location:

Las Vegas, Nevada, USA

Note:

This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.
If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC Field

Value

Language

dc.type.category

Abstract

en_US

dc.type

Presentation

en_GB

dc.title

CHALLENGES TO PUTTING EVIDENCE INTO PRACTICE: THE MUCOSITIS PROJECT ONE YEAR LATER

At ONS congress 2006, an evidence-based standard of care for the prevention and treatment of oral mucositis was presented by this group of nurses. Approval for the new standard was obtained from this NCI designated Cancer Center's medical board, clinical council, and executive nursing committee. Variations in nursing practice triggered this project. This new standard of care has been fully implemented throughout all disease management teams of the ambulatory, inpatient, and chemotherapy areas. This presentation will describe challenges to achieving this evidence- based practice change and strategies used to overcome them. Changes to institutional supply of toothbrushes and rinse agents were requested based on the evidence, as part of a new oral care protocol. Cost analysis and potential benefit were presented to several committees, and finally approved. Nursing education presented the greatest challenge. A new assessment tool (CTCAE V.3) and oral care protocol were presented at a series of in-services. An animated PowerPoint presentation enabled nurses to grade varied photos of mucositis and compare their assessment with the actual toxicity grade for self-directed learning. Common terms were defined and clarified to increase nurses' fluency regarding mucositis. Videos were developed summarizing the evidence, new tool, and oral care protocol. These were used for unit based in-services and placed on the intra-net to target nurses at regional sites whose education presented a geographic challenge. These videos have been incorporated into annual competency review and orientation for all nurses. Advanced practice nurses were recruited as trainers and resources. A single patient education booklet reflective of the new oral protocol replaced three previous documents. Noted challenges included maintaining literacy parameters and utilizing feedback from expert review. Mucositis assessment and management are documented on multiple forms spanning this institution. Arduous revisions were necessary to reflect the new mucositis grading system. Documentation reviews and practice surveys will discern impact on nursing practice. Promoting development of evidence-based practices has become conventional at many institutions. However, implementing these changes proved more complex than initially anticipated. Each challenge was met with different strategies for accomplishing the goal. Communication, flexibility, and cooperation proved imperative to successful implementation of this practice change.

en_GB

dc.date.available

2011-10-27T12:14:44Z

-

dc.date.issued

2011-10-27

en_GB

dc.date.accessioned

2011-10-27T12:14:44Z

-

dc.conference.date

2007

en_US

dc.conference.name

32nd Annual Oncology Nursing Society Congress

en_US

dc.conference.host

Oncology Nursing Society

en_US

dc.conference.location

Las Vegas, Nevada, USA

en_US

dc.description.note

This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.
If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

-

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